title: Changes in insurance status and access to care in an integrated safety net healthcare system.
abstract: This paper focuses on a cohort of uninsured patients that have accessed outpatient healthcare services in an urban safety net, evaluating the degree to which they switch insurance status and the impact this switching has on access to care. The results indicate that in an integrated safety net system, there is a high frequency of insurance status switching by the uninsured. Uninsured patients who switch to insured status were found to be more likely to visit specialty points of care and less likely to visit urgent points of care than the continuously uninsured. It is well documented that insurance coverage and continuity of care influence health status. Continuity of insurance coverage also has an impact on access to care for those receiving services within a safety net healthcare system.
authors.affiliation: Department of Health Systems, Management and Policy, School of Public Health, Denver Health and Hospital Authority, Health Services Research, University of Colorado Denver Health Sciences Center, Denver, CO 80204-4507, USA. sheri.eisert@dhha.org
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Eisert
authors.forename: M Joshua
authors.initials: MJ
authors.lastname: Durfee
authors.forename: Adrienne
authors.initials: A
authors.lastname: Welsh
authors.forename: Susan L
authors.initials: SL
authors.lastname: Moore
authors.forename: Philip S
authors.initials: PS
authors.lastname: Mehler
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Gabow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000706:statistics & numerical data* / Q000639:trends; D007348:Insurance, Health; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult